TABLE 2.

Recommended Immunizations for Adults With Cancer

Vaccine	Recommended Age	Schedule
Influenzaa	All ages	Annually
RSV	60 years and older	Once
COVID-19	All ages	As per the latest CDC schedule for immunocompromised17
Tdap or Tdb	19 years and older	One dose of Tdap, followed by Td or Tdap booster every 10 years
Hepatitis B	19-59 years: eligible 60 years and older: immunize those with other risk factorsc	For adults 20 years and older, use high antigen (40 µg) and administer as a three-dose Recombivax HB series (0, 1, 6 months) or four-dose Engerix-B series (0, 1, 2, 6 months)18
Recombinant zoster vaccine	19 years and older	Two doses at least 4 weeks apart
Pneumococcal vaccine	19 years and older	One dose PCV15 followed by PPSV23 8 weeks later OR One dose PCV20d
HPV	19-26 years: eligible 27-45 years: shared decision making	Three doses, 0, 1–2, 6-months

NOTE. Adapted from CDC Adult Immunization Schedule By Medical Condition and Other Indication.¹⁵ Information linking to US trade names for each vaccine is available and routinely updated at the CDC's website on vaccines.¹⁶ Coadministration of two or more of the recommended nonlive vaccines is acceptable per CDC guidelines. When given on separate days, there is no recommended waiting period. Note, PCV-15 and PPSV-23 should be separated by at least 8 weeks as noted in the table.

Abbreviations: CDC, Centers for Disease Control and Prevention; HPV, human papillomavirus; PCV, pneumococcal conjugate vaccine; PPSV-23, 23 valent Pneumococcal polysaccharide vaccine; RSV, respiratory syncytial virus; Td, tetanus and diphtheria; Tdap, tetanus, diphtheria and pertussis.

^a Live attenuated influenza vaccine, which is administered as a nasal spray, cannot be given to patients with cancer.

^b Tdap has lower amounts of diphtheria and pertussis toxoid and is only used for those 7 years and older. DTaP, the pediatric vaccine for prevention of tetanus, diphtheria, and pertussis, is only for children younger than 7 years.

^c HIV, chronic liver diseases, intravenous drug use, sexual risk factors, incarcerated individuals.

^d Patients who have previously received PCV13 only can receive one dose of PCV 20 after an interval of 1 year.